Form 1012 - Application For Industrial Facilities Tax Exemption Certificate Page 4
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4Form 1012, Page 4
6. Affidavit of Fees (signed by the local unit of government
and the applicant), (Bulletin 3, January 16, 1998). This
statement may be incorporated into the Letter of
Agreement (see sample).
7. Treasury Form 3222 (if applicable) - Fiscal Statement
for Tax Abatement Request.
The following information is required for rehabilitation
applications in addition to the above requirements:
1. A listing of existing machinery, equipment, furniture and
fixtures which will be replaced or renovated. This listing
should include description, beginning date of installation
or expected installation by month/day/year, and costs
or expected costs.
2. A rehabilitation application must include a statement from
the Assessor showing the taxable valuation of the plant
rehabilitation district, separately stated for real property
(EXCLUDING LAND) and personal property. Attach
a statement from the assessor indicating the
obsolescence of the property being rehabilitated.
The following information is required for speculative
building applications in addition to the above
requirements:
1.A certified copy of the resolution to establish a speculative
building.
2.A statement of non-occupancy from the owner and the
assessor.
Please refer to the following Web site for P.A. 198 of 1974:
For guaranteed receipt by the State Tax Commission, it is
recommended that applications and attachments are sent
by certified mail.
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